HURST REVIEW NCLEX RN Book-PDF 2022/2023
PRACTICE QUESTIONS GUIDE WITH REVISED
ANSWERS
what is fluid volume excess/hypervolemia? - ANS>> too much fluid in the
vascular soace
what are causes of fluid volume excess? - ANS>> heart failure or renal
failure
what are diseases with too much aldosterone? - ANS>> Cushings and
hyperaldosteronism (Conn's)
what are diseases with too little aldosterone? - ANS>> Addisons
ADH makes you retain what? - ANS>> WATER
what is another name for ADH? - ANS>> vasopressin
Too Much ADH = - ANS>> retaining of water, FVE, SIADH
Too Little ADH = - ANS>> diurese water, FVD, DI
What are signs of FVE? - ANS>> distended neck veins, peripheral edema
or third spacing, CVP, crackles, polyuria, tachycardia, hypertension, weight
gain
what is FVE treatment? - ANS>> low Na diet/fluid restrictions, DW, I/O,
diuretics
what are causes of FVD? - ANS>> loss of fluid from anywhere
(thoracentesis, vomiting, diarrhea, hemorrhage), third spacing (burns,
ascites), polyuria, DM
Isotonic solutions: goes into the vascular space and stays there - ANS>>
examples: NS, LR, D5W and D5 1/4 NS
uses: nausea/vomiting, burns, sweating, and trauma
,alert: do not use in clients with HTN, cardiac or renal diseases
what are signs of FVD? - ANS>> weight loss, decreased skin turgor, dry
mucous membranes, decreased UO, hypotension, tachycardia, weak
thready pulses, increased RR, decreased CVP, cool extremities, increased
urine specific gravity
hypotonic solutions: goes into the vascular
space and then shifts out into the cells to replace cellular fluids; rehydrates
- ANS>> examples: D2.5W, 1/2 NS, 0.33%NS
uses: HTN, renal or cardiac disease, fluid replacement from N/V, burns,
hemorrhage
alert: watch for cellular edema
hypertonic solutions: volume expanders that will draw fluid into the vascular
space from the cells - ANS>> examples: D10W, 3%NS, 5%NS, D5LR, D5
1/2NS, D5NS, TPN, albumin
uses: hyponatremia, severe edema, burns, ascites
alert: watch for FVE, monitor in an ICU setting esp if they are receiving
3%NS or 5%NS
Quick Tip IV Solutions - ANS>> Isotonic Solutions: Stay Where I Put It
Hypotonic Solutions: Go Out Of The Vessel
Hypertonic Solutions: Enter The Vessel
Hypermagnesemia and Hypercalcemia act like a ?? - ANS>> Sedative
What are causes of hypermagnesemia? - ANS>> renal failure, antacids
what are common signs of both hypermagnesemia and hypercalcemia? -
ANS>> decreased DTR, weak or flaccid muscle tone, arrhythmias,
decreased LOC, decreased HR and RR
Mg: flushing and warmth, vasodilation
Ca: brittle bones, kidney stones
what are causes of hypercalcemia? - ANS>> hyperparathyroidism,
thiazides, immobilization
, What is normal Mg and Ca level? - ANS>> Mg: 1.3-2.1
Ca: 9-11
What is treatment for hypermagnesemia? - ANS>> ventilator if RR <12,
dialysis, calcium gluconate
what is treatment for hypercalcemia? - ANS>> movement, increased fluids,
increase phosphorous in diet, steroids, calcitonin or biphosphates
Hypomagnesemia and hypocalcemia are opposite? - ANS>>
hypermagnesemia and hypercalcemia
NOT ENOUGH SEDATIVE
What are causes of hypomagnesemia? - ANS>> diahrrea, alcoholism
what are causes of hypocalcemia? - ANS>> hypoparathyroidism, radical
neck, thyriodectomy
what are common signs seen in both hypomagnesemia and hypocalcemia?
- ANS>> rigid and tight muscle tone, seizures, strider or laryngospasms, +
Chvostek, +Trousseaus, arrhythmia, increased DTR, mind changes
(psychosis), swallowing problems
What is treatment for hypomagnesemia? - ANS>> Give mag, check kidney
function, seizure prec
what is treatment for hypocalcemia? - ANS>> PO and IV calcium, vitamin
D, phosphate binders (Sevelamer hydrochloride, calcium acetate)
Hypernatremia vs Hyponatremia - ANS>> hyper: too much Na, not enough
water = dehydration
hypo: too much water, not enough Na = dilution
what are causes of hypernatremia? - ANS>> hyperventilation, heat stroke,
DI
what are causes of hyponatremia? - ANS>> Drinking water for fluid
replacement, Psychogenic polydipsia (loves water), SIADH
PRACTICE QUESTIONS GUIDE WITH REVISED
ANSWERS
what is fluid volume excess/hypervolemia? - ANS>> too much fluid in the
vascular soace
what are causes of fluid volume excess? - ANS>> heart failure or renal
failure
what are diseases with too much aldosterone? - ANS>> Cushings and
hyperaldosteronism (Conn's)
what are diseases with too little aldosterone? - ANS>> Addisons
ADH makes you retain what? - ANS>> WATER
what is another name for ADH? - ANS>> vasopressin
Too Much ADH = - ANS>> retaining of water, FVE, SIADH
Too Little ADH = - ANS>> diurese water, FVD, DI
What are signs of FVE? - ANS>> distended neck veins, peripheral edema
or third spacing, CVP, crackles, polyuria, tachycardia, hypertension, weight
gain
what is FVE treatment? - ANS>> low Na diet/fluid restrictions, DW, I/O,
diuretics
what are causes of FVD? - ANS>> loss of fluid from anywhere
(thoracentesis, vomiting, diarrhea, hemorrhage), third spacing (burns,
ascites), polyuria, DM
Isotonic solutions: goes into the vascular space and stays there - ANS>>
examples: NS, LR, D5W and D5 1/4 NS
uses: nausea/vomiting, burns, sweating, and trauma
,alert: do not use in clients with HTN, cardiac or renal diseases
what are signs of FVD? - ANS>> weight loss, decreased skin turgor, dry
mucous membranes, decreased UO, hypotension, tachycardia, weak
thready pulses, increased RR, decreased CVP, cool extremities, increased
urine specific gravity
hypotonic solutions: goes into the vascular
space and then shifts out into the cells to replace cellular fluids; rehydrates
- ANS>> examples: D2.5W, 1/2 NS, 0.33%NS
uses: HTN, renal or cardiac disease, fluid replacement from N/V, burns,
hemorrhage
alert: watch for cellular edema
hypertonic solutions: volume expanders that will draw fluid into the vascular
space from the cells - ANS>> examples: D10W, 3%NS, 5%NS, D5LR, D5
1/2NS, D5NS, TPN, albumin
uses: hyponatremia, severe edema, burns, ascites
alert: watch for FVE, monitor in an ICU setting esp if they are receiving
3%NS or 5%NS
Quick Tip IV Solutions - ANS>> Isotonic Solutions: Stay Where I Put It
Hypotonic Solutions: Go Out Of The Vessel
Hypertonic Solutions: Enter The Vessel
Hypermagnesemia and Hypercalcemia act like a ?? - ANS>> Sedative
What are causes of hypermagnesemia? - ANS>> renal failure, antacids
what are common signs of both hypermagnesemia and hypercalcemia? -
ANS>> decreased DTR, weak or flaccid muscle tone, arrhythmias,
decreased LOC, decreased HR and RR
Mg: flushing and warmth, vasodilation
Ca: brittle bones, kidney stones
what are causes of hypercalcemia? - ANS>> hyperparathyroidism,
thiazides, immobilization
, What is normal Mg and Ca level? - ANS>> Mg: 1.3-2.1
Ca: 9-11
What is treatment for hypermagnesemia? - ANS>> ventilator if RR <12,
dialysis, calcium gluconate
what is treatment for hypercalcemia? - ANS>> movement, increased fluids,
increase phosphorous in diet, steroids, calcitonin or biphosphates
Hypomagnesemia and hypocalcemia are opposite? - ANS>>
hypermagnesemia and hypercalcemia
NOT ENOUGH SEDATIVE
What are causes of hypomagnesemia? - ANS>> diahrrea, alcoholism
what are causes of hypocalcemia? - ANS>> hypoparathyroidism, radical
neck, thyriodectomy
what are common signs seen in both hypomagnesemia and hypocalcemia?
- ANS>> rigid and tight muscle tone, seizures, strider or laryngospasms, +
Chvostek, +Trousseaus, arrhythmia, increased DTR, mind changes
(psychosis), swallowing problems
What is treatment for hypomagnesemia? - ANS>> Give mag, check kidney
function, seizure prec
what is treatment for hypocalcemia? - ANS>> PO and IV calcium, vitamin
D, phosphate binders (Sevelamer hydrochloride, calcium acetate)
Hypernatremia vs Hyponatremia - ANS>> hyper: too much Na, not enough
water = dehydration
hypo: too much water, not enough Na = dilution
what are causes of hypernatremia? - ANS>> hyperventilation, heat stroke,
DI
what are causes of hyponatremia? - ANS>> Drinking water for fluid
replacement, Psychogenic polydipsia (loves water), SIADH
